Some, I hope premature, final thoughts – THE LAST DITCH.
Having raised some concerns in the linked post, I thought I should update you, gentle readers, on my health. Foolishly, I forgot that my private health insurance offers online GP consultations, so I waited ten days to see my regular GP instead. She thought it was more likely – given my history of clotting – that I had clots rather than heart disease but gave me a general letter of referral to a cardiologist. Armed with that, it took a further four days to get my health insurer to agree some names and a hospital. I economised on my health cover last renewal by excluding the flashy fully private hospitals of Central London. So we settled on Hammersmith Hospital and I approached a consultant in the private wing there. Three days later I had an appointment.
The episode of which I wrote in the linked post was on 19th October. My first appointment with a specialist was on 11th November. Better than NHS standards, but not great – given that something serious is amiss. I was careful, lived quietly (thus missing one of the greatest evenings at Craven Cottage in recent memory, alas) and no further episodes ensued. Until November 9th that is – two days before my appointment with the consultant.
My sister is a member of a Midlands choir and had asked some time ago if she could stay with me on her way to singing choral evensong at Rochester Cathedral. I’d said I would happily drive her from my place to and from the cathedral. It would make a nice outing for me – and I’d never heard choral evensong. After the Villa Match episode, I decided to go ahead, but engage in some of that perfect planning and preparation the SAS assures us prevents piss-poor performance. I booked a private parking space 300 yards from the cathedral with one of those “park on my driveway” apps. The restaurant where the choir would eat afterwards was between the parking space and the cathedral so I was never going to to walk more than 150 yards in one go. As the rest of the time would be sitting around while my sister rehearsed and performed, I reasoned I’d be fine.
So I would have been, but the choir decided, after a triumphant performance (I’m still not religious alas, but sacred music can be – and this was – truly beautiful) to head to a “nearby” pub. The pub was up a hill and proved to be closed – so the trek continued longer. This resulted in a repeat of what happened at Craven Cottage on the 19th October. There were two doctors in the choir – one the Head of Medicine at a Birmingham hospital – and she observed my symptoms and said something was seriously wrong.
Two days later I ended up seeing my consultant cardiologist in Harley Street. My insurer had warned that if my doctor chose to see me somewhere other than agreed – and commissioned tests from there – they might not be covered, but when I called to clear the change of venue they signed off on it promptly. I was given an ECG, echocardiogram, blood tests and a CT scan. The CT scan hadn’t been pre-authorised (at £1,500 a go, it’s a big item) but – again – a quick call to my insurer resulted in approval. So much for my £1,000 excess on the policy – another piece of retirement income conserving! The nurse doing the scan said the results would be in 48 hours, but my consultant saw me on the way out and gave them to me immediately.
Sure enough, there are plaques (chalky buildups) narrowing the arteries in my heart. One of them is quite big and seemed to account for my symptoms. I was referred to (with my insurer’s pre-approval) to another consultant to discuss doing an invasive angiogram. This would confirm the state of my heart and – if deemed necessary – a stent could be inserted at the time. If a stent wasn’t necessary, it would be dealt with my medication. I was prescribed beta-blockers, statins and aspirin in the meantime. This all seemed clear enough and could have been far worse. No-one was proposing to penetrate me with a scalpel. We knew the problem and had a solution. All seemed well.
Fate had other plans however. When I had a video consult on Wednesday afternoon with the cardiologist who will do the angiogram, he reported that the blood tests had suggested clots. I reported that my left leg had swelled up below the knee that day and was painful and tight. He said that brought our consultation to an end as I should adjourn immediately to A&E. It sounded like I had a clot in my leg that could migrate to my lungs and I needed urgent attention. He suggested the emergency care unit at the Cromwell (where the late Mrs P. was treated and ultimately died) but that’s one of the flashy hospitals I’m – thanks to late-onset frugality – not now covered for, so I headed to St Mary’s Hospital A&E instead.
That was an interesting experience last night. The staff were efficient enough (one of them was friendly and amusing) but generally it wasn’t the courteous and considerate experience I’d had in Harley Street on Monday. I had planned to have drinks and dinner with Miss P. the Younger and – when I called to cry off – she offered to come with me to the hospital. That made for a much less stressful experience and I was very grateful.
Afer a couple of bits of triage, a nervous young doctor examined me and didn’t inspire much confidence. He adjourned to report to a senior consultant and returned to tell me that I did probably have a clot but no scan was possible until 11.30 am today. So he gave me the blood thinners they’d prescribe for the clot and asked me to come in today for the scan. That might have made me nervous. My consultant had been pretty clear that I was at risk and yet I was being sent home. I thought I might not get much sleep but then surprised myself by saying “f*** this, worrying won’t cure anything ” and slept like a a baby.
I was at the hospital on time this morning and was scanned pretty quickly using a flashy modern machine made by a corrupt European company of which I throughout disapprove. The print-out from this machine that probably costs a small fortune looks like it was produced by a toddler with a crayon!
My leg is so swollen that they couldn’t get a definitive result. So I waited for a doctor to analyse the scan. She said she was going to assume there was a clot and treat me accordingly. She prescribed a longer supply of the blood thinners and said the anti-coagulation team would follow up in a few weeks. There’d then be another scan and a decision would be made on where we go from there.
I asked for copies of their test/scan results and emailed them to my two private cardiologists. The first one has called me already to take me off the aspirin he’d prescribed as that would conflict with the thinners.
I expressed my disappointment when he said we might have to delay the angiogram while we allow the treatment for my clot to play out. I said I’d follow advice, obviously, but that my inclination would be to get on with whatever was needed as quickly as possible. Until the clot emerged, the plan had been to fix my heart – one way or another – within two working days. That felt like a good return on my investment in health insurance to me, given that I would have had to wait in a Soviet-style queue for each of the battery of tests I had on Monday and would probably not have had a diagnosis for weeks in consequence.
He understood that and said he’d feel the same way. He said he’d speak to his colleague who was to do the angiogram and have him call me to discuss next steps. He duly did at 6pm today and is happy to proceed with the angiogram and will aim to do it on Monday morning. He’s working at the Cromwell then, but has asked the CEO of the hospital (which is actually owned by my health insurer) to see if he can get special clearance for me to be treated there. Having read me the warnings his lawyers require him to give and secured my consent, we left it that I should block out Monday for treatment and expect to be home with my heart fixed by mid-afternoon.
